Month: December 2015

According to a report, the cost of healthcare is driving millions of Indians into poverty. / Picture from INDIAN EXPRESS

INDIAN EXPRESS | VIKRAM PATEL | DECEMBER 21 2015

Earlier this month, The Lancet published a paper calling for a radical transformation of the architecture of India’s healthcare delivery system if it is to achieve the government’s vision of assuring health for all. The paper documented India’s progress on major health indicators in the past decade, but also its many deficiencies. The most disturbing indicator of these deficiencies is the observation that the cost of healthcare is driving millions of Indians into poverty. Let us pause to consider the implication of this statement.

In a country where the primary goal of economic development is to help raise people out of poverty, healthcare is driving millions into poverty. Whereas, in other countries, investment in healthcare is recognised as a route to promote growth by enhancing their citizens’ capabilities to be productive, healthcare in India is now one of the leading causes of poverty. We are, in simple terms, out of step with the rest of the world, not only the developed countries whose ranks we aspire to join, but also with other countries like ours.

It is common to lay the entire blame, or at least the lion’s share, for this on the government. This is certainly true to some extent, but the reality is that many…continue reading

Health practitioners have come to realise that the top-down approach has not yielded desired results in the development paradigm. They are now restructuring social and development practices to create a sense of ownership in the target community to the programme. This has meant significant involvement of the community for design and delivery. Special care has been taken by programme designers to include more vulnerable sections of the society.

In case of healthcare delivery interventions, the focus on involving the community has been even more evident. This is partly because the success of a health programmes depends largely on its acceptance by the people.

New insights in healthcare

Preventive health programmes like immunisations are aimed at the entire population and are focused on otherwise healthy people. Thus, the onus of making these programmes a success shifts from people to provider, as healthy people have no immediate need for seeking out health services. Compulsory measures have often backfired, causing a shift to communication and education to increase reception of the programme. Volunteers drawn...continue reading

THE FLOODWATERS devastating large parts of the Himalayan state of Jammu and Kashmir caught the people and the government unawares, it is said. But why should this be so? We know every year, like clockwork, India grapples with months of crippling water shortage and drought and then months of devastating floods. This year offers no respite from this annual cycle but something new and strange is afoot. Each year, the floods are growing in intensity. Each year, the rain events get more variable and extreme. Each year, economic damage increases and development gains are lost in one season of flood or severe drought.

Scientists now say conclusively that there is a difference between natural variability of weather and climate change, a pattern brought about by human emissions that is heating up the atmosphere faster than normal. Scientists who study the monsoons tell us that they are beginning to make that distinction between normal monsoon…continue reading

After two successive crop failures, the rabi crop this year looked promising, but hailstorm spells dashed all hopes.

A farmer on his drought-hit field at Gehra village in Mahoba district in the Bundelkhand region of Uttar Pradesh on Tuesday. Photo: Rajeev Bhatt / Picture from THE HINDU

THE HINDU | OMAR RASHID | DECEMBER 2 2015

Moolchand Kumar Prajapati and Jaidevi broke down as they spoke of their son Sunil, 24, who hanged himself last week.

The past year was exceptionally difficult for the Prajapati family, which owns barely 1.5 bighas (about half an acre) of land at Gehra village of Mahoba district in the heart of Bundelkhand. After two successive crop failures, the rabi crop this year looked promising, but a few spells of hailstorm dashed all hopes. Reeling under a debt of Rs. 2 lakh, the fresh stretch of drought, the third year in a row, proved to be the crippling blow for a dispirited Sunil. He left behind his wife and a month-old infant. “He lost his mental balance under this stress,” Moolchand says.

As thousands of families in Bundelkhand hit by severe drought, Moolchand’s family struggles for survival. They could grow only 25 kg of oilseeds in the season and have to travel 10 km on a broken path to the nearest market to buy basic food items. This is the worst crisis faced by the family,..continue reading